Membership Application
To apply for membership please complete all questions.
Name
First Name
Last Name
Address
*
Street Address
Street Address Line 2
Germiston
Gauteng
Postal / Zip Code
E-mail
example@example.com
Membership Type
Please Select
Family R250.00
Pensioner R100.00
Business R500.00
Home Number
Cellular Number
Work Number
Signing Date
-
Month
-
Day
Year
Date
Are there any skills that PRA could request from you?
Apply for Membership
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